Acne vulgaris is an inflammatory disease of the pilosebaceous glands characterized by an eruption of the skin, often pustular in nature but not suppurative. Acne is a common affliction of the adolescent and affects a small but significant percentage of the adult population. Acne lesions are of four basic types: comedones (blackheads or whiteheads), papules, pustules, and cysts (or nodules). Various topical agents are utilized in the treatment of acne and these include sulfur, resorcinol, salicylic acid, benzoyl peroxide, vitamin A acid and topical antibiotics. Acne involvement results in unslightly lesions, particularly on the face, and in some cases results in severe scarring.
There are a variety of methods for treating acne vulgaris including topically applying various scrubbing or abrasive compositions, topically applying deep cleaning or astringent compositions and also exposure to ultraviolet radiation. Nevertheless, acne vulgaris is seldom cured and only can be contained with difficulty. Carbamide peroxide is an agent used to soften earwax for removal (Debrox.RTM. Drops (International Pharmaceutical Corporation, 9233 Ward Parkway, Kansas City, Mo. 64114); Ear Drops by Murine (Abbott Laboratories, North Chicago, Ill. 60064) and to provide cleansing action in the oral cavity (Gly-Oxide.RTM. Liquid (International Pharmaceutical Corporation, 9233 Ward Parkway, Kansas City, Mo. 64114).
In treating two young adults with Debrox.RTM. Drops to cleanse their ears of earwax, I noted that blackheads, whiteheads, and some acne papules and pustules in front of ears cleared rapidly. I thought this might have resulted from spillage out of the ear or inadvertent application of the eardrops to these areas. Subsequently I tested topical formulations containing carbamide peroxide for effectiveness in acne and found surprisingly that carbamide peroxide applied topically to the skin is useful in the treatment of acne vulgaris. Also, surprisingly carbamide peroxide achieves such beneficial effects without much of the irritating and sensitizing effects of benzoyl peroxide. I have also found that combinations of carbamide peroxide with certain chemical agents known to be effective in treating acne are more effective in treating acne than would be expected by treatment with the individual agents themselves. Such formulations include combinations of carbamide peroxide and one or more of nicotinamide or topical anbitiotics such as erythromycin base, clindamycin phosphate and tetracycline hydrochloride.